Pediatric Final
Terms
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- An infant born with a myelomenigocele should be in which position?
- Prone position always or on side.
- What are nursing priorities post-op for a myelomenigocele?
- Avoid infection, antibiotics, sterile technique, maintain moist sterile, non-adherent saline dressing to sac.
- What is the cause of myelomenigocele?
- Severe genetic predisposition and folic acid deficiency from mother.
- What are the different forms of spina bifida?
-
Spina bifida oculta (bony defect - missing bone)
Spina bifida dystica meningocele (meninges are exposed)
Myelomeningocele - meninges and spinal cord protruding. - What supplement is suggested to prevent this disease?
- Folic Acid
- How can spina bifida be predicted while still in utero?
- Prenatal alphfetoprotein level checked at 16 weeks.
- What are the signs and symptoms of hydrocephalus?
- Neural functions
- What are nursing priorities post-op for shunt placement?
- Monitor for infection or malfunction of shunts.
- What teaching should parents receive after a child gets a shunt?
- Be able to recognize signs of infection to shunts
- What symptoms do you look for if a shunt has complications?
- Neural function stops.
- What are signs and symptoms of an infant with ICP?
- Irritable, double vision, dycoplia.
- What nursing strategy is done to prevent increased ICP in the unconscious child?
- Semi-fowlers position.
- What should parents do with care of unconscious but stable child?
- Talk, touch, and associate like normal.
- What is an epidural hematoma?
- Bleeding between the dura and skull.
- What is a subdural hematoma?
- Bleeding between the dura and the brain.
- After a minor head injury, what S&S may indicate a need for medical help?
- Change in Level of consciousness, change in behavior.
- What is decorticate posturing?
- Aduction of the hand and feet toward the cord.
- What is decerebrate posturing
- Abduction of hands and feet.
- What symptoms do you see with spastic cerebral palsy?
- Muscle stiffness.
- What is the major goal of therapy for children with Cerebral Palsy?
- Child will develop to the best potential.
- What test is done to diagnose meningitis?
- Lumbar puncture.
- How is a lumbar puncture done?
- Child is lying on his side. Hold the head and legs.
- What specimen is obtained in a lumbar puncture?
- Cerebrospinal fluid.
- What is the priority nursing care for a child with bacterial meningitis?
- Administer medication as soon as possible.
- What vaccine is available to prevent meningitis?
- Hepatitis B.
- What type of illness precedes Reyes Syndrome?
- Viral Infection such as the flu.
- What does an absence seizure look like?
- Daydreaming. Staring into space.
- What information is important to gather about absence seizure?
- When, type, how many episodes, any information.
- After a tonic-clonic seizure, what symptoms would be expected?
- Lethargy, Headache, sleepy, fatigue.
- What nursing interventions are done for failure to thrive?
- The parent needs to know when the child is hungry (feed on demand)
- Mental retardation is caused by?
- Various genetic biochemical, viral, nutritional factors.
- IQ of 30 is described as?
- Sever retardation (needs constant directional supervision)
- The best method for early detection of cognitive deficit is?
- Routine developmental assessment tests (Denver screening)
- The priority nursing diagnosis for a child with cognitive dysfunction with limited ability to ancitipate danger is?
- Safety
- What is monitored during the first year of life in a child with Down's syndrome?
- Cardiac and GI disorders.
- What is the most common disorder of Down's Syndrome children?
- Congenital heart defects.
- What are the major features of a child with Down's Syndrome?
- Simian Crease on palm, hypotonic muscles.
- With a hospitalized child with Down's Syndrome, what would a nurse do?
- Encourage the parents to stay with the child.
- What is myopia?
- Near-signtedness (image focusing in front of retina)
- What is conjuctivitis?
- Pink eye, bacterial, viral chemical, alergic infection (never touch the tip of the medication applicator)
- Eye surgery puts a child at risk for?
- Infection of the eyes
- The priority nursing diagnosis for a child with eye surgery is?
- Treat the patient as if their vision is impaired (announce your presence when entering the room)
- How is the eye patch placed on a child for strabismus?
- The patch is placed on the stronger eye to strengthen the weaker eye.
- Is strabismus normal for a 5-month-old?
- No. It's normal for a 4-month-old.
- If an infant stops babbling, what should be assessed?
- Hearing
- How do nurses meet the needs of children with hearing loss?
- Get their attention, look face to face.
- What are the symptoms of visual-impaired children?
- Squinting, rubbing eyes frequently.
- What are signs and symptoms of hypokalemia?
- Hypoactive bowel sounds, low potassium, below 3.5mEq/L.
- What is the priority nursing diagnosis when caring for infants with dehydration?
- Monitor I&O, daily weight checks.
- What assessment should be done before administering IV solution with Potassium to a child with dehydration?
- Urinating well.
- What is the primary concern with persistant vomiting?
- Find the cause.
- Do we give antidiarrheal medication to toddlers?
- No, will prolong diarrhea.
- What are the teaching concerns with diarrhea in children?
- Monitor skin turgor, monitor for low BP, tachycardia, mucous membranes moist, capillary refill.
- What are the signs and symptoms of dehydration?
- No urination for 6 hours, notify doctor.
- How do we treat dehyration at home?
- Oral rehydration, pedialyte, gatorade.
- How do we avoid the spread of gastroenteritis?
- Hand washing.
- What are the complications of severe dehydration?
- Renal failure, immature function of kidneys make children more prone to dehydration.
- What is the most common test for pinworms?
- Scotch tape test immediately upon wakening.
- What is the cause of cleft lip?
- Unknown
- How do you help parents cope with cleft lip?
- Show before and after surgery pictures. (Encourage parents to verbalize feelings.)
- What is the post-op care for cleft lip?
- Mittens, elbow restraints, do not put face down.
- What is pre-op care for cleft lip?
- Provide suction needs (pacifiers and nipples.)
- What maternal conditions relate to the infants diagnosis of TEF?
- Polyhydramnios (too much amniotic fluid)
- What is the nursing care of an infant with TEF?
- Place in upright position until surgery (NPO)
- What is a major symptom of pyloric stenosis?
- Olive size bulge in the RUQ, vomiting, visible perstalsis.
- What is intussusception?
- Telescoping of the bowels.
- What is an assessment finding in infants with intussusception?
- Current Jelly stool.
- What is the first step in emergency treatment of poisoning?
- Assess the patient first.
- What is the most common source of lead poisoning?
- Lead paint.
- What is the discharge teaching for an infnat with GE Reflux?
- CPR, Risk for aspiration.
- What is celiac disease?
- An intolerance to foods with gluten such as wheat, barley, rye and oats.
- What is the priority nursing diagnosis for a child with celiac disease?
- Altered nutrition less than body requirments.
- What are classic symptoms of celiac disease?
- Abdominal distention, thin arms & legs, foul smelling stool.
- What is an assessment finding with hirschsprungs disease?
- Constipation.
- What is the nursing care post-op of Hirschsprungs disease?
- No rectal temps, colostomy care.
- What are the symptoms of a recently ruptured appendix?
- Sudden relief of pain.
- What are the appropriate interventions for a ruptured appendix?
- No heat to abdomen, IV fluids, CBC, pain medications.
- What is the treatment for thrush?
- Antifungal cream. (apply to gums with gloves)
- What is the oral treatment for ringworm?
- Griseofulvin po q 12 hours.
- What is impetigo?
- Bacterial infection of the skin, papule and vesicle around the mouth.
- What is the treatment for impetigo?
- Antibacterial meds. 48 hr. after starting antibiotics - can return to school.
- What causes cellulitis?
- It is secondary to injury and infection.
- What is the nursing priority for a child with herpetic gingivostomatis?
- Risk for dehydration due to sore mouth.
- What is the treatment for Herpes simplex virus?
- Oral antiviral medication.
- What are the side effects of anti-lice products?
- Neuro toxin effects.
- What are the signs and symptoms of lice?
- Itching
- What are the complications of atopic dermatitis?
- Impetigo.
- What are the classifications of burns?
-
First - Superficial
Second - Partial - Epidermis & Dermis
Third - Full - all 3 layers of skin - What is the relationship between the prognosis?
- More tissue damage - more severe
- What is the priority outcome of mandatory newborn screening?
- Hypothyroidism
- The lack of growth hormones lead to what metabolic alteration?
- Hypoglycemia - low glucose.
- What are the symptoms fo hypoglycemia?
- Sweating, pallor, low sugar between 60-80, give simple sugars.
- What is the honeymoon phase of diabetes?
- The pancreas starts to produce insulin for 1-6 months.
- What should a diabetic child do who plays sports?
- Eat more carb snacks.
- What is a good age to administer insulin?
- Age 9-12
- Know proper care for type 1 diabetes and need for education.
- Teenager states "I can't wait till I'm older so I can take a pill"
- What does a teenager with diabetes think?
- I just want to be like everyone else.
- What labs are associated with diabetes ketoacidosis?
- Acidosis pH levels below 7.0
- How should pH levels below 7.0 be treated?
- Go to hospital - life threatening.
- What are some teaching items for UTI prevention?
- Cotton underwear, no bubble bath, cranberry juice.
- What are the symptoms of UTI?
- Abdominal pain, enuresis, dysuria, polyuria, hematuria.
- Why are girls more prone to UTI's?
- They have a shorter urethra and are more susceptible to infection.
- What is a sign that a person with acute post-streptococcal glomerulonephritis is showing improvement or recovery?
- Increased urination.
- What are complications and symptoms of acute post-streptococcal glomerulonephritis?
- Edema, crackles in lungs, tea color urine.
- What does it mean if you have casts in the urine?
- Glomerular injury.
- What are diagnostic findings associated with nephrotic syndrome (Phephrosis)?
- Protein in the urine, hypoalbumin, edema.
- What is a sign that nephrotic syndrome (Phephrosis) is in remission?
- No protein in the urine for 2 weeks.
- What is the treatment for Nephrotic Syndrome (Phephrosis)?
- Corticosteroids.
- What is a no-salt diet?
- No salt in cooking or on table.
- What is a nursing intervention for a child with nephrotic syndrome?
- Risk for impaired skin integrity - turn every 2 hours.
- What is a teaching item for a child with vesicoureteral reflux?
- Importance of taking antibiotics.
- What is the best way to examine an infant for cryptorchisism?
- Warm room, warm hands.
- What age should hypospadias be accomplished by?
- 18 months.
- Why is it corrected early?
- To maintain a good body image.
- What is epispadias?
- Dorsal placement of urethral opening.
- What are the effects of chemotherapy?
- Suppression of immune system (bone marrow)
- What are signs and symptoms of leukemia?
- Bone pain, weakness, pallor, bruising, weight loss, enlarged lymph nodes.
- Why would a child scream when moving?
- Bone pain.
- What is the priority nursing diagnosis for a newly diagnosed leukemia patient?
- Infection control.
- What test is done to confirm a leukemia diagnosis?
- Bone marrow biopsy.
- Why does a leukemia patient have excessive bleeding?
- They have low platelets.
- What is a home going teaching item for parents of a child with leukemia?
- Take temp routinely to catch infection in the early stages.
- How do you respond to guilt about not taking child to Dr. sooner?
- It is normal to overlook subtle changes in a child's health.
- What are S&S of Hodgekin's disease?
- Non-tender lymph nodes, enlarged firm, no pain, lethargy, pruritis.
- What is the appropriate care for a child with Wilm's tumor?
- Do not palpate abdomen
- What is the post-op treatment for a child with Wilm's tumor?
- Chemotherapy with or without radiation.
- What are hallmark symptoms of a child with a brain tumor?
- Headache, vomiting in the morning.
- What is the significance of a neuroblastoma-embryonic tumor in utero?
- Diagnosis after its metastis.
- What is the most common site for a osteogenic sarcoma (bone cancer)?
- Femur
- What electrolyte disturbance causes cardiac dysrhythmia?
- Hyperkalemia - High potassium levels.
- What is the most common way of contracting HIV in children?
- Perinatal
- What are the signs and symptoms of malignant hyperthermia?
- High temperature.
- What is the appropriate way to give a tepid sponge bath?
- If the child is chilled - stop bath.
- What is the most reliable way to determine safe dosage for a child?
- Body weight in Kg.
- What is a nursing consideration when using a mist tent?
- Keep the child warm and dry.
- What is a papule?
- An elevated circumscribed area such as a wart or mole.
- What is a nodule?
- An elevated area that is firm and round.
- What is a vesicle?
- An elevated area that is round, superficial such as chicken pox, herpes zoster.
- What is a pustule?
- A pus filled area such as herpes simplex or acne.